Naso-gastric tube retainer

Abstract

An adhesive device retains a medical tube, and particularly a naso-gastric tube, in relation to a patient with improved flexibility, strength and adhesion. The device includes a nose pad portion for attaching to a patient's nose and a tube attachment section for attaching to the naso-gastric tube. A substantially inelastic spine extends across a narrow or otherwise vulnerable neck portion, which connects the nose pad to the tube attachment section. The spine strengthens the retaining device against tensile and shear forces while allowing flexibility. At the same time, deflection of the spine does not cause internal elastic stresses sufficient to counter adhesion of the retainer to either the patient or the medical tube.

What is claimed is: 
     
       1. A naso-gastric tube retainer having a nose end and a tube end defining a longitudinal axis therebetween, the retainer comprising: a nose pad at the nose end of the retainer, including a structural layer and an adjacent adhesive layer;   a tube attachment section at the tube end of the retainer, including a structural layer and an adjacent adhesive layer;   a longitudinal neck connecting the nose pad to the tube attachment section, wherein the neck is narrower in a dimension perpendicular to the longitudinal axis than each of the nose pad and the tube attachment section; and   a flexible, substantially inelastic spine extending at least the length of the neck and being affixed to at least two locations on the neck that are spaced from each other along the longitudinal axis.   
     
     
       2. The naso-gastric tube retainer of claim 1, wherein the spine exhibits a longitudinal tensile strength of at least about 25 lbs./inch. 
     
     
       3. The naso-gastric tube retainer of claim 2, wherein the spine exhibits a longitudinal tensile strength of at least about 40 lbs./inch. 
     
     
       4. The naso-gastric tube retainer of claim 1, wherein the spine has a modulus of elasticity of less than about 150,000 p.s.i. 
     
     
       5. The naso-gastric tube retainer of claim 4, wherein the spine has a modulus of elasticity of less than about 100,000 p.s.i. 
     
     
       6. The naso-gastric tube retainer of claim 1, wherein the spine exhibits a shear strength in a direction perpendicular to the neck of at least about 0.8 p.s.i. 
     
     
       7. The naso-gastric tube retainer of claim 6, wherein the spine exhibits a shear strength in a direction perpendicular to the neck of at least about 1.2 p.s.i. 
     
     
       8. The naso-gastric tube retainer of claim 1, wherein the longitudinal neck includes a structural layer and an adjacent adhesive layer, and the structural and adhesive layers of the nose pad are continuous across the neck with the structural and adhesive layers of the tube attachment section to form a unitary structural layer and a unitary adhesive layer. 
     
     
       9. The naso-gastric tube retainer of claim 1, further comprising a removable liner adjacent to and directly contacting at least one of the adhesive layers of the nose pad and the tube attachment section. 
     
     
       10. The naso-gastric tube retainer of claim 1, wherein the nose pad further includes another structural layer adjacent said structural layer, said structural layer being interposed between said another structural layer and the adhesive layer, and the tube attachment section further including another structural layer adjacent said structural layer of the tube attachment section, said structural liver of the tube attachment section being interposed between said another structural layer and the adhesive layer of the tube attachment section. 
     
     
       11. The naso-gastric tube retainer of claim 10, wherein the spine is interposed between the second structural layer and the structural layer of each of the nose pad and the tube attachment section. 
     
     
       12. The naso-gastric tube retainer of claim 1, wherein the spine is coextensive with the length of the retainer along the longitudinal axis. 
     
     
       13. The naso-gastric tube retainer of claim 1, wherein the spine is narrower than the neck. 
     
     
       14. The naso-gastric tube retainer of claim 1, wherein the structural layers comprise a polyester. 
     
     
       15. The naso-gastric tube retainer of claim 14, wherein the structural layers comprise a spunlaced nonwoven fabric. 
     
     
       16. The naso-gastric tube retainer of claim 1, wherein the spine comprises a high-density polyethylene. 
     
     
       17. A one-piece naso-gastric retainer having an upper portion, a lower portion, and a neck portion connecting the upper portion to the lower portion, the retainer comprising: a first structural layer;   an adhesive layer adjacent the first structural layer;   a second structural layer adjacent the first structural layer; and   a spine secured between the first structural layer and the second structural layer, at least as narrow as the neck portion of the retainer and extending at least the length of the neck portion, comprising a substantially inelastic, flexible material with a tensile strength greater than that of the first and second structural layers.   
     
     
       18. The naso-gastric retainer of claim 17, wherein the neck portion is relatively more narrow than each of the upper portion and the lower portion. 
     
     
       19. The naso-gastric retainer of claim 17, wherein each of the upper and lower portions comprises a right lobe and a left lobe defining a concave longitudinal end of the retainer. 
     
     
       20. The naso-gastric tube retainer of claim 17, wherein the spine has a modulus of elasticity of less than about 100,000 p.s.i. 
     
     
       21. An adhesive, external anchoring device for attaching a medical tube to the body of a patient, comprising: an first end portion comprising an adhesive pad for securing the device to a patient, having at least a section with a width of greater than about 1 inch and at least a section with a length of greater than about 1 inch;   a second end portion comprising an adhesive pad for securing the device to a naso-gastric tube;   a neck portion, narrower than the first end portion and the second end portion, connecting the first end portion to the second end portion; and   a spine fixed to both the first end portion and the second end portion and extending the length of the neck portion.   
     
     
       22. The device of claim 21, wherein the spine comprises a flexible material. 
     
     
       23. The device of claim 21, wherein the spine comprises a substantially inelastic material. 
     
     
       24. The device of claim 23, wherein the spine material has a modulus of elasticity of less than about 150,000 p.s.i. 
     
     
       25. The device of claim 21, wherein the device comprises two layers of structural material and the spine is interposed between the two layers. 
     
     
       26. A naso-gastric tube retainer, comprising: an upper end portion including first means for attaching the retainer to the nose of a patient;   a lower end portion including second means for attaching the retainer to a naso-gastric tube; and   a flexible, substantially inelastic spine affixed to and extending between the upper end and the lower end portions.   
     
     
       27. The naso-gastric tube retainer of claim 26, wherein the first means for attaching the retainer to a nose of a patient comprises a medical grade adhesive layer. 
     
     
       28. A medical tube retainer, comprising: a first pad for attaching to the skin of a patient;   a second pad for attaching to a medical tube, said second pad being spaced from the first pad; and   means for coupling the first and second pads together and for inhibiting the space between the first and second pads from increasing, while allowing all other degrees of movement of the second pad relative to the first pad without producing substantial internal stress in the retainer.